Provider Demographics
NPI:1447705165
Name:WELL BEING ENDO
Entity type:Organization
Organization Name:WELL BEING ENDO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MSD
Authorized Official - Phone:561-543-1995
Mailing Address - Street 1:266 NW PEACOCK BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2271
Mailing Address - Country:US
Mailing Address - Phone:772-340-2242
Mailing Address - Fax:772-340-7290
Practice Address - Street 1:266 NW PEACOCK BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2271
Practice Address - Country:US
Practice Address - Phone:772-340-2242
Practice Address - Fax:772-340-7290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN164411223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty